This Sacred Congregation has diligently considered not only the problem of
contraceptive sterilization for therapeutic purposes but also the opinions
indicated by different people toward a solution, and the conflicts relative to
requests for cooperation in such sterilizations in Catholic hospitals. The
Congregation has resolved to respond to these questions in this way:

1. Any sterilization which of itself, that is, of its own nature and condition,
has the sole immediate effect of rendering the generative faculty incapable of
procreation, is to be considered direct sterilization, as the term is understood
in the declarations of the pontifical Magisterium, especially of Pius XII1.
Therefore, notwithstanding any subjectively right intention of those whose
actions are prompted by the care or prevention of physical or mental illness
which is foreseen or feared as a result of pregnancy, such sterilization remains
absolutely forbidden according to the doctrine of the Church. And indeed the
sterilization of the faculty itself is forbidden for an even graver reason than
the sterilization of individual acts, since it induces a state of sterility in
the person which is almost always irreversible.

Neither can any mandate of public authority, which would seek to impose direct
sterilization as necessary for the common good, be invoked, for such
sterilization damages the dignity and inviolability of the human person2.
Likewise, neither can one invoke the principle of totality in this case, in
virtue of which principal interference with organs is justified for the greater
good of the person; sterility intended in itself is not oriented to the integral
good of the person as rightly pursued “the proper order of goods being
preserved”3 inasmuch as it damages the ethical good of the person,
which is the highest good, since it deliberately deprives foreseen and freely
chosen sexual activity of an essential element. Thus article 20 of the
medical-ethics code promulgated by the conference in 1971 faithfully reflects
the doctrine which is to be held, and its observance should be urged.

2. The Congregation, while it confirms this traditional doctrine of the Church,
is not unaware of the dissent against this teaching from many theologians. The
Congregation, however, denies that doctrinal significance can be attributed to
this fact as such, so as to constitute a “theological source” which the faithful
might invoke and thereby abandon the authentic Magisterium, and follow the
opinions of private theologians which dissent from it4.

3. Insofar as the management of Catholic hospitals is concerned:

a) Any cooperation which involves the approval or consent of the hospitals to
actions which are in themselves, that is, by their nature and condition,
directed to a contraceptive end, namely, in order that the natural effects of
sexual actions deliberately performed by the sterilized subject be impeded, is
absolutely forbidden. For the official approbation of direct sterilization and,
a fortiori, its management and execution in accord with hospital
regulations, is a matter which, in the objective order, is by its very nature
(or intrinsically) evil. The Catholic hospital cannot cooperate with this for
any reason. Any cooperation so supplied is totally unbecoming the mission
entrusted to this type of institution and would be contrary to the necessary
proclamation and defense of the moral order.

b) The traditional doctrine regarding material cooperation, with the proper
distinctions between necessary and free, proximate and remote, remains valid, to
be applied with the utmost prudence, if the case warrants.

c) In the application of the principle of material cooperation, if the case
warrants, great care must be taken against scandal and the danger of any
misunderstanding by an appropriate explanation of what is really being done.

This Sacred Congregation hopes that the criteria recalled in this letter will
satisfy the expectations of that episcopate, in order that, with the
uncertainties of the faithful cleared up, the Bishops might more easily respond
to their pastoral duty.

Franjo Cardinal ŠeperPrefect

Most Rev. Jérôme Hamer, O.P. Titular Archbishop of Lorium
Secretary

l. Cf. especially the two Allocutions to the Catholic Union of Obstetricians
and to the International Society of Hematology: AAS 43 (1951)
843-844; 50 (1958) 734-737 and in the encyclical of Paul VI, Humanae Vitae,
14: AAS 60 (1968) 490-491.